Dear colleagues,

i would appreciate your help with this echo.

Dear colleagues,

i would appreciate your help with this echo.

This patient (age unknown but not too young, probably 10+y old, presented for echo and abdominal scan to investigate mild gradual but consistent weight loss over the past few months. No obvious signs of CHF (although owner has not been instructed to monitor SRR up to now). CBC and biochemistry normal, I have not seen any xrays from this patient. Abd scan nothing too significant, and asucultation: no obvious heart murmur nor abnormalitties. We Obviously missed the murmur since the echo shows mitral valve degeneration and MR. But also…there is tricuspid regurgitation, pulm insufficiency and I can even see some Aortic insufficiency. Pulm valve appears to have some subvalvular echogenic tissue which I cannot identify whether is normal or not (I assume its not).

LA:Ao ratio is 1.4…

M-Mode measurements:

RVDd: 6.8mm

IVSd: 6mm

LVDd: 26.4mm

PWdia: 9.8

IVSsys:11.4

LVDsys: 15.5mm

PW sys: 12.0mm

EF: 74%,FS: 41%

any input…?